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Related Experiment Video

Updated: Jul 2, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Circumflex to Left Atrial Appendage Fistula Associated With Watchman FLX Closure Device.

Stefan Milutinovic1, Juan Lopez-Mattei2, Jeffrey Rosen2,3

  • 1Florida State University College of Medicine Internal Medicine Residency Program at Lee Health, Cape Coral, Florida, USA.

JACC. Case Reports
|February 21, 2024
PubMed
Summary

A Watchman FLX device implantation complication led to a fistula between the left circumflex artery and the left atrial appendage. This rare event caused dyspnea in an elderly patient, highlighting potential risks of cardiac device procedures.

Keywords:
complicationcomputed tomographycoronary angiography

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Complications

Background:

  • The Watchman FLX device is used for left atrial appendage closure.
  • Complications following device implantation require thorough investigation.

Purpose of the Study:

  • To report a rare complication of Watchman FLX device implantation.
  • To describe the diagnostic evaluation of a post-procedural fistula.

Main Methods:

  • Case report of an 82-year-old male patient.
  • Multimodality imaging for fistula diagnosis.
  • Review of anatomical proximity between the left circumflex artery and left atrial appendage.

Main Results:

  • A small fistula was identified between the proximal circumflex artery and the left atrial appendage.
  • The patient presented with dyspnea following Watchman FLX device implantation.
  • Anatomical proximity supports fistula formation as a late complication.

Conclusions:

  • Fistula formation is a potential, albeit rare, late complication of Watchman FLX device implantation.
  • Multimodality evaluation is crucial for diagnosing such complications.
  • Understanding anatomical relationships is key to anticipating device-related risks.